What’s the News: The bacterial hordes that call your mouth home—and yes, even if you brush rigorously, you’ve got ‘em—are generally a pretty benign bunch. Mostly they just mooch around, snagging tastes of whatever you’re eating, but Streptococcus mutans, the bad boy that causes cavities, releases tooth-corroding acid whenever you eat sugar. Even mouthwash that kills everything it touches can’t save you from the ravages of S. mutans in the long term; it just grows back, along with the rest of your bacteria.

Scientists who study the mouth microbiome, however, think that a mouthwash that kills S. mutans and leaves the rest of the bacteria to take over S. mutans‘s real estate could spell the end of cavities. In a small clinical study last year, one team found that one application of the mouthwash knocked down S. mutans levels, and that harmless bacteria grew back in its place. If the mouthwash pans out, it could join the ranks of an emerging new type of treatment: better living through hacking the microbiome.

How the Heck:

The team, whose work is funded by toothpaste manufacturer Colgate-Palmolive, had designed a molecule called C16G2 that had been proven to kill S. mutans in Petri dishes. C16G2 is what’s called an antimicrobial peptide—it seeks out a particular type of bacteria and inserts itself in or attaches itself to the cell membrane, causing the bacterium to self-destruct.

To see whether C16G2 would work in an actual mouth, they first crafted 12 plastic retainers for volunteers to wear that had slots to hold chips of enamel taken from cow teeth. (This provided a way to see if tooth enamel was eroded by the acid S. mutans secretes; grinding volunteers’ actual teeth to check for enamel hardness would be frowned upon.)

After taking samples of the volunteers’ baseline bacteria, the researchers had them swish with sugar water to get S. mutans active, and then had them swish once with a mouthwash containing C16G2. Over the next four days, they had the volunteers repeated the sugar water swishing and took samples of their mouth bacteria daily.

The researchers found that numbers of S. mutans in volunteers’ mouths fell dramatically over the trial period, while in control tests without the C16G2 mouthwash, S. mutans populations grew. With the mouthwash, the cow enamel stayed hard, while in control tests, it softened.

Interestingly, the total number of bacteria in volunteers’ mouths was about the same at the end of the study as at the start; “healthy” bacteria had moved in on S. mutans‘ turf. The researchers mention that previous studies have shown that once healthy bacteria have taken over all the territory in the mouth, S. mutans can have a hard time getting another foothold.

Not So Fast:

This study is so small that it’s really only useful as a way to inform future, larger studies, and to ascertain that C16G2 doesn’t fall totally flat at the first sight of a normal person’s mouth. But it does pique the imagination.

What’s the Context:

Treatments that manipulate humans’ complement of bacterial hangers-on are getting a lot of attention these days. Though the idea of probiotics—substances or foods intended to replenish stores of “good” bacteria—has been around for a while, researchers are now starting to be able to study microbial communities in detail, thanks to advances in cheap and easy DNA sequencing.

It’s worth keeping in mind, too, that what exactly a healthy microbiome is probably varies from person to person. A study last year indicated that people may fall into one of three gut microbiome types, analogous to blood types. The same could be true for the other colonies than call us home.

The Future Holds: The next step is to try a much larger experiment of similar design, and should that produce similar results, deal with these pressing questions: How long do the effects last? Can the newly healthy bacterial community withstand repeated attacks from S. mutans invaders? And how long would it take for S. mutans to develop a resistance?

Curing cavities has been a perennially “just around the corner” grail for medicine… I remember first reading about an imminent cavities vaccine in the late 1970s. So we’ll see!

“The researchers found that numbers of S. mutans in volunteers’ mouths fell dramatically over the trial period”

Any treatment that kills most of a bacterial population always leads to a resistant strain developing very quickly.

Bob Snyder

Wouldn’t this be nice…

Cathy

Too late for my mouth. Although the 5x flouride prescription toothpaste I got switched to a few years back has halted by tooth decay almost entirely.

John Lerch

Mr (MS) Tall Blue Ape
The point is that it’s the other bacteria which keep the S mutans down–not a chemical. And the chemical is gone right away and so resistance can’t develop And the other bacteria will evolve to counter the change in the S mutans.

Scott

Oh, sign me up! I’ve been waiting for exactly this for years!
The real solution is flora, not fluoride.

Monica

Sounds great but I think you’ll need another dose if you kiss someone…

Scott Williams

The law of unintended consequences follows in the wake of all genetic engineering promises. They’re long on all the ‘so-called’ beneficial aspects to GE but short on the broad environmental impact and health-related studies. The motives are ALWAYS profit, tinkering aside, weighed against a very narrow risk equation.

And considering how our illustrious dental industry has saddled the US population, for over 50 years mind you, with Fluoride and mercury amalgam, just what makes you think they’ve somehow got this right? They’re all about drilling and filling. If tooth decay were to go away, they couldn’t enjoy their golf day.

Z.

As a dental student, I am taught that it’s not just Str. mutans which causes the dip in pH level and demineralization, but many other species as well.

JCHarris

What happens to the biome outside the mouth after the rinse is used? I presume it would be spit out into the sink or the swirly-water-thing at the dentist’s? Is it going to randomly take out S. mutans in the sewers? Leave a few to mutate into giant, rampaging super-bugs that want our pizza?

Seriously, though, what larger effect? Unintended consequences bite.

http://winchesternaturalhealth.com Shiva Barton, ND

There is already an agent that kills off S. mutans and is safe for humans. It is xylitol, the sweetener used in sugarless gum. There have been studies that even show using an oral swish in mother’s mouth before delivery of their babies can reduce the number of cavities in those children by preventing the after-birth transmission from mother to child. So, its pretty effective. The reason you don’t hear about it is that it costs pennies and it isn’t patentable.

floodmouse

Instead of using a chemical to kill a specific bacteria, couldn’t you just swish with a helpful probiotic that competes with the harmful bacteria? Something packaged along the lines of Five Lac, which is a kind of Japanese probiotic, though what goes into the package might be tailored to suit the purpose.